Can my V shape butt be corrected with a BBL? (Photo)

Question

Hi, I have previously had a BBL done but I am not happy with my results , I told my surgeon I really wanted the underneath of my butt to be corrected and have a nice shape but this unfortunately wasn’t done. My question is , can the underneath of my butt be corrected through fat transfer or am I wasting my time going back for a round 2 ? I will attach a photo with what I am left with , I had lipo 360 a tummy tuck and a BBL , could the butt be corrected so I could have a nice rounder shape?

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

You are in good company with many others who had high hopes for BBL but instead received disappointing results (lumpiness, unevenness, lack of projection in the central and/or lower buttock, post-deflation sagging, fatty necrotic cyst or scar tissue, etc.) as most of the fat melts away. It is not quite as much the quality of the doctor nor liposuction technique but rather the quality of the procedure that is a large part of the problem.  Thus, going back for additional rounds of BBL most often produces the same disappointing results but at another financial loss.   Beware, if a surgeon asks you to purposely gain weight (i.e. fat) before BBL, know that the fat you lose first as you get back to your baseline weight after surgery is that very same fat that was transferred into your buttock, hence your new buttock shrinks first, the fastest, and the most...so please do not fall victim to this recommendation.

Fillers, such as Sculptra and hyaluronic acids,  for augmentation of the buttock/hips are a rip-off, period!

Buttock implants, however, provide a more reliable, predictable, relatively safe, and permanent result, especially for adding projection to the buttock and often smoothing out lumpiness. Occasionally a lower buttock tuck may be advantageous for lower buttock fold asymmetries and/or sagging.  When considering buttock implants make sure that the surgeon is going to be placing the implants within gluteus muscles , (a.k.a. “intramuscular pocket”), and that they are using anatomically correct, oval-shaped implants, such as Stanton Anatomic ®️ implants.

Finally, you may also benefit from some revision liposuction of your love handle areas. This can be done at the same time as buttock implants.

Please keep in mind that an extremely few number of board-certified plastic surgeons specialize in these buttock implants so be sure to consult with one that is reputable and experienced. Unfortunately you may have to travel long and far away from home to find this particular surgeon. Glad to help.

Luis A. Mejia, MD · Answer

Dear Slt12345678910
Thanks for sharing your concerns and picture. I rather suggest to get a BBL revision and also a dog ears correction will help with your concern about hips and provide with an awesome frame. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks!

Daniel Barrett, MD · Answer

Dear Slt12345678910,
I understand your concern. Based on your photos, it looks like you would need revision surgery. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Kenneth R. Francis, MD, FACS · Answer

Dear slt,
Depending on the initial conditions present BBL is sometimes a staged procedure, i.e. needs to be repeated or revised.  Too many patients that have extreme needs also have extremely unrealistic expectations.  We have no idea what your pre-operative appearance and needs were and your result may be perfectly acceptable.  In addition, the results of BBL are somewhat unpredictable in terms of fat survival and retention.  The good news is that you are probably a candidate for a BBL revision surgery.  Return to your physician, or another, for an examination and discussion of your options.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the pictures they took. For any assessment or a future consultation you should come prepared bringing with you you were before and after pictures and ideally a copy of your operative report. These are all available from your providers office if you request them. 
Your body contour can easily be improved by either doing an excision of the excess skin in your dog ears, with or without Liposuction. The droopy lower inner part of your buttocks cannot be fixed with that transfer. Correcting the contour of your buttocks will require a skin excision, sometimes called a tuck. To get a better understanding of the condition and I was treated as a just watching a YouTube video by Dr. mendieta called the Miami thong lift.
The video describes the condition it’s best treated. You may have to look around to find the right provider to help you with this, but it cannot be fixed with either Liposuction or fat transfer.
The contour issue in your love handles is easy to fix, but not the lower part of your buttocks as described above.
I generally recommend patients not having a BBL combined with a full tummy tuck as a single procedure. It’s a lot of surgery to do in one day and surgeons who are detail oriented. Take the time needed to make sure results are correctly obtained. The times when multiple procedures are done at the same time, shortcuts are taken and results do not come out as well as they could have. It’s not to say there are not advantages and appropriate times to combine procedures. The combined tummy tuck, full body liposuction, and BBL is in my opinion better done as two separate procedures. 
Generally, speaking revision work is more difficult than primary liposuction or fat transfer. The best shot for getting a quality outcome is always during the first procedure. That said, in your case I think some obvious improvements will be fairly straightforward, but the charging area is going to be the inner lower part of your buttocks. 
I personally don’t know many plastic surgeons to do that procedure or do it well. I’m sure there’s plenty of providers out there who can help you but you may have to look around and have multiple consultations before finding the right person.
The biggest mistake patients make when scheduling cosmetic surgery is not being thorough in regards to vetting plastic surgeons and not having enough consultations. I suggest patient schedule multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of the previous patient went similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 15 previous patients. Being shown a handful of pre-selected images, representing the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they’ve actually performed. There’s no correct number of consultations needed to find the right provider. The more consultations you haven’t been more likely you are to find the best provider. Considering how much variation there is in body contouring outcomes I suggest patients start the process by having at least five in person consultations 
I generally recommend people avoid virtual consultations whenever possible, and try not scheduling surgery, requiring long-distance travel, if at all possible.
Best,
Mats Hagstrom, MD
Good luck,
Mats Hagstrom MD

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